Croup

Croup is characterized by a barking cough, hoarseness, and stridor (a high-pitched breathing sound). It occurs chiefly in infants and children.

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(Source: NIH - National Library of Medicine)

What works? Research summarized

Evidence reviews

Glucocorticoids for croup

Croup is common in children and is thought to be triggered after a viral infection. Croup causes swelling in the throat and windpipe (trachea) and causes hoarseness, a barking cough and noisy breathing. Croup usually gets better by itself but sometimes drugs are used to try and improve this condition. The review looked at trials of one type of steroid drug, glucocorticoids. Glucocorticoids can reduce the swelling and make it easier for the child to breathe. We found that glucocorticoids can start improving croup in children within six hours (14 studies, 1031 children). The effect lasts about 12 hours (eight studies, 532 children), lessens the need for other drugs, and shortens hospital stays by 12 hours (eight studies, 795 children). There were no adverse events associated with glucocorticoids. Additional studies are needed to determine the best dose of glucocorticoids.

Nebulized epinephrine for croup in children

This review looked at trials of inhaled epinephrine for the treatment of children with croup and is comprised of only eight studies with 225 participants. Of the eight included studies, six were assessed as having low risk of bias and two as unclear risk of bias (based upon assessment of adequate random sequence generation, allocations concealment, blinding of participants and personnel, blinding of outcome assessment, completeness of outcome data, and selective reporting). Studies assessed a variety of outcome measures and few studies examined the same outcomes; therefore, most outcomes contained data from a maximum of three studies, and in some cases only single studies.

Helium‐oxygen (heliox) treatment for croup in children

Croup is an acute illness commonly seen in children up to six years of age but mostly by the age of two. It is triggered by viral infections causing upper airway obstruction with varying degrees of respiratory distress. Mostly, it is mild and transient and resolves with supportive care. Croup is characterised by a barking cough, hoarseness, varying degrees of inspiratory stridor (abnormal breathing sound) and chest wall retractions and is usually preceded by one to three days of upper respiratory tract infection symptoms. The peak croup seasons are autumn and winter but can occur at any time.

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Summaries for consumers

Glucocorticoids for croup

Croup is common in children and is thought to be triggered after a viral infection. Croup causes swelling in the throat and windpipe (trachea) and causes hoarseness, a barking cough and noisy breathing. Croup usually gets better by itself but sometimes drugs are used to try and improve this condition. The review looked at trials of one type of steroid drug, glucocorticoids. Glucocorticoids can reduce the swelling and make it easier for the child to breathe. We found that glucocorticoids can start improving croup in children within six hours (14 studies, 1031 children). The effect lasts about 12 hours (eight studies, 532 children), lessens the need for other drugs, and shortens hospital stays by 12 hours (eight studies, 795 children). There were no adverse events associated with glucocorticoids. Additional studies are needed to determine the best dose of glucocorticoids.

Nebulized epinephrine for croup in children

This review looked at trials of inhaled epinephrine for the treatment of children with croup and is comprised of only eight studies with 225 participants. Of the eight included studies, six were assessed as having low risk of bias and two as unclear risk of bias (based upon assessment of adequate random sequence generation, allocations concealment, blinding of participants and personnel, blinding of outcome assessment, completeness of outcome data, and selective reporting). Studies assessed a variety of outcome measures and few studies examined the same outcomes; therefore, most outcomes contained data from a maximum of three studies, and in some cases only single studies.

Helium‐oxygen (heliox) treatment for croup in children

Croup is an acute illness commonly seen in children up to six years of age but mostly by the age of two. It is triggered by viral infections causing upper airway obstruction with varying degrees of respiratory distress. Mostly, it is mild and transient and resolves with supportive care. Croup is characterised by a barking cough, hoarseness, varying degrees of inspiratory stridor (abnormal breathing sound) and chest wall retractions and is usually preceded by one to three days of upper respiratory tract infection symptoms. The peak croup seasons are autumn and winter but can occur at any time.

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Terms to know

Cough
A cough is a natural reflex that protects your lungs. Coughing helps clear your airways of lung irritants, such as smoke and mucus (a slimy substance).
Glottis
The middle part of the larynx; the area where the vocal cords are located.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Stridor
Stridor is a high-pitched breath sound, caused by a narrowed or obstructed airway.
Subglottis
The lowest part of the larynx; the area from just below the vocal cords down to the top of the trachea.
Viral Infections
A general term for diseases produced by viruses.
Vocal Cords
One of two small bands of muscle within the larynx that vibrates to produce the voice.
Voice Box (Larynx)
The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

More about Croup

Photo of a child

Also called: Croup syndrome, Acute obstructive laryngitis, Laryngotracheobronchitis

Other terms to know: See all 8
Cough, Glottis, Inflammation

Related articles:
About Fever in Children

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